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Monday, September 30, 2013

Intrusive sex involves boundary violations without discovery and, although it is passivise-aggressive, the energy behind the perversion is anger. A man cuts a hole in his hotel room in order to spy on the sexual on-goings of the couple next door. He could have rented porn video if all he wanted was sexual arousal, but he want the sexual arrousal with a mandatory add-on: He has to violate the privacy boundaries of the sexual actors. His high comes from the emotions attendant on the forbidden access to what he was taught is a shameful act.

Bobby's grandmother scared him. A large woman with a booming voice, she commanded attention and seemed to suck the air out of the room. Bobby's mother was no match for her domineering mother.
"She's a nut job," Bobby's dad said.

Bobby, the youngest of five, was often left in his grandmother's care, when he learned to stay as far from her as possible, which meant playing outside. But this, too, had its dangers. coming home dirty would cause an uproar, and his grandmother would spank Bobby or give him a beating.

Even worse moments would occur when Bobby wet his pants. This happened frequently because Bobby was so frightened of entering the house when his grandmother was there. Bobby internalized his grandmother's shameless, red-faced rage. "You are disgusting and dirty," she would yell.

Although wetting himself was an accident born out of fear, Bobby was taught that to be himself, to be human, was to be disgusting and dirty.

After he wet himself, Bobby would be thrown into a cold bath. Scrubbing his penis with a rough cloth, his grandmother would tell him, "This is a dirty thing, a dirty thing. We have to scrub away your dirty little thing."

Bobby dared not provoke her further by crying out. He would shut his eyes, hold his breath, and wait until her fury abated.

"What are the changes?" I ask.
"Almost all the woman in the sales department have filed a complaint."

Bobby again becomes the humiliated boy who so long ago was terrified by his grandmother. His eyes are full of fear.

The rage that Bobby had stuffed had begun to leak out by the age of ten.

"I started touching women in stores," Bobby explains.
He would pretend that it was inadvertent. "I would let my hand brush up against their crotch or their butt. It was such a high."
"By ten you were doing this?"
"Yeah, I would even practice doing it in my bedroom to perfect my technique. What was so great was that, as a kid, it was so easy; that never said anything, even though I knew they felt it. That big problems started when I was entered high school."

Bobby began touching girls in the crowded hallways, and making inappropriate sexual comments and obscene phone calls.

"This was before call ID, cell phones, or any of that, but they could still trace calls," Bobby continues.

"That's the first time you got caught?"
"Yeah, when I was fourteen."
Bobby's high was in the release of his unbridled rage on unsuspecting women. Crowded hallways, public events like ball games and theater lobbies, and tight quarters such as the cabin of an airplane became prime acting-out territories.
"And then came the Internet," Bobby says. "That's when my addiction really exploded."

It's late as Bobby sits hunched over his computer; the glow of the screen is the only light in the room. Deep in concentration, he adjusts the remote cameras' focus with his keyboard controls. He has installed three cameras, one for each stall in the women's bathroom.

"Had you installed other cameras," I ask.
"Not yet, but I had been thinking about how to install some at the women's locker room at the gold club."

Through his traumatic wounding, Bobby created a distorted sexual template that justifies his intrusive acts. In the haze of his addiction, Bobby's high comes from the emotions attendant on his forbidden access to what he was taught is dirty and shameful.

He sees women as disgusting, and he has the right to demean their sexuality the way he was demeaned. While holding himself safe from rebuke, he holds them in utter contempt, judging them from behind a wall of sexualized anger. In the one-up position of moral condemnation, he escapes the one-down position of having been condemned for the very same act. Now he is in control, and now he has the power.

Sunday, September 29, 2013

It is a fine autumn day as I cut across campus. It is my first fall in the high desert, and I am surprised at how brisk the air is, despite the sunshine, I shiver as I grab the door to the main building, rushing to my office in an attempt to shake off my chill.

A group of patients has gathered outside my office, looking as if they are condemned inmates heading to the gallows. I image their expression are due to feelings of anxiety about the group process that is about to begin.

Paige, the only woman in my group, pulls up the end of the procession, plopping herself down in the nearest chair. Still chilled from the 40-degree weather, I notice her multicolored sundress: sleeveless, loose-fitting, and draping to her ankles.

"Let's get started," I say, clapping my hands and attempting to help them shake off their somber expressions. "Let's get out our notebooks," I begin, "and go over... " Stopping mid-sentence, I am distracted as Paige, now bending over to retrieve her notebook, has "inadvertently" exposed her bare breasts. Six men (all heterosexuals) sit with their mouths open, looking at me for some sort of cue.

The shock felt by the victims is the high for the exhibitionist; it is where she feels power and control. This is a passive-aggressive behavior that, for women, is often couched in a naive innocence of intention. They are exempt from responsibility because of the cultural denial that the woman would ever intentionally be so provocative. One out of four girls will be sexually assaulted by the age of eighteen. For boys, it is one out of six. We have to ask: Where does all of that sexual shame and anger get channeled? The answer is that it gets channeled into sexual compulsive behavior. Paige's behavior was intentional.

As with many of the acting-out behaviors we have discussed, the exhibitionist rarely if ever wants to be sexual. The power for her is in controlling her victim.

When Paige exposes herself, she is seeking to reverse her childhood trauma, and banish fear and shame by becoming her perpetrator. The sexual pleasure of the perversion masks her underlying shame.

It is late afternoon, and Paige notices Mr. Bentley, who sits, as he always does, on a lawn chair on his front porch. Mrs. Bentley, who died three months ago after a heart attack, left emptiness in the hearts of her family members. She was the quintessential grandmother.

Paige, like all of the neighbors, had seen a fast decline in Mr. Bentley's health. To Paige, he seemed to have gone off the deep end. Two days ago, while Paige was sitting in her favorite chair across from Mr. Bentley, he had allowed his penis to be exposed in the loose-fitting shorts. At first, Paige was curious and confused, and then she was disgusted. Paige, too embarrassed to tell anyone, let the incident go, excusing it as just an accident.

A few days later, Paige's mother made the suggestion that, while she and Paige's father were away dropping off her brother at college, Paige could stay with Mr. Bentley. She thought it would be the perfect situation because Paige, too young to be left alone, could keep Mr. Bentley company. Paige, too afraid to tell her mother what had happened, acquiesced.

Mr. Bentley's sexual behaviors escalated immediately. Leaving the bathroom door open while he urinated, wearing the same loose shorts, and standing naked in front of Paige while she pretended to be asleep, Mr. Bentley turned Pagige's stay into a horror show.

"What are you feeling, Paige?" I ask as tears stream down her face.
Her male peers, who are giving her feedback, have hit a nerve.
"I don't know; I guess sad."
"You know, Paige, I feel sad when I see you do that to yourself," says Max, one of her fellow group members.
"Over the past few days, I have started to get to know you, and I think you are a valuable person. I just don't think I know you yet."
Paige bows her head in an attempt to hide her face."I never had anybody say these things to me," she says, tears still streaming. "I feel like such an asshole."
"Paige," I say with focus, "you are not an asshole. You are just a person who was traumatized, trying to take back your power the only way you know how. Now you have the opportunity to learn a new way, a healthy way to heal your wounds and express your sexuality."

Friday, September 27, 2013

The sexual exhibitionist compulsively attracts attention to the sexual parts of his or her body, regardless of the appropriateness. We often think of the man in the appropriateness. We often think of the man in the trenchcoat hiding in the bushes, springing out to expose himself. but in our culture, a great deal of exhibitionism is now considered normal. There is exhibitionism at the beach, in advertising, and on television. Sexual flaunting has become so much of a part of accepted culture that many sexual exhibitionists usually seek therapy only when they have gotten in trouble with family, business, or the law.

Say a man is walking down the street at night and stops and stares at a woman who inadvertently exposes herself by undressing while standing near a window in her lit bedroom with her blinds up. Chances are, if a police officer walks by, he will arrest the man as a Peeping Tom. The woman's display of nakedness so embarrasses this cop's notion of woman's Madonna-like modest that he concludes the "always horny male" is the perpetrator.

In reality, woman exhibit themselves all the time, and our culture supports this behavior, especially through sexually provocative advertising and Hollywood box-office stereotypes. So, for woman, exhibitionism is often rewarded, where as exhibitionistic men are considered perverts. This is a sad state of affairs because exhibitionism hurts everyone involved without regard to gender or sexual preference.

Often in the childhood of the sexual exhibitionist, a primary caregiver has exposed himself, causing fusion of fear and sexual arousal. Now when the victim exposes himself, he sees to reverse the childhood trauma and banish fear and shame by becoming the perpetrator. The sexual pleasure of the perversion masks the underlying dysfunction (fear and shame), and an addiction takes hold.

Thursday, September 26, 2013

The next part of the cycle is ritualization. All addicts have rituals, whether they are aware of them or not. Rituals reinforce and intensify the experience. Once when I was giving a lecture at The Meadows, I asked one of the clients if he had a ritual. He said, "No." I asked how he acted out, and he said he cruised for prostitutes.

"So you don't have a ritual?" I asked.
"No," he said.
"Well, where do you cruise?"
"Downtown."
"Never uptown?"
"No, always downtown."
I continued with a barrage of questions.
"Do you cruise at a specific time of day? Do you wear particular clothing? How do you carry your money? Do you drink coffee or alcohol, or smoke? Do you listen to music? What kind of woman do you look for: tall, short, large-breasted, dark skin, blonde hair?"

His answer painted a very specific ritual that came as a surprise to him as he unraveled the specifics.

"I cruise downtown, between midnight and 5 a.m. I have a cooler in my trunk where I have a bottle of vodka on ice. I have a plastic cup I got from some car wash. I place two ice cubes in the cup and sip on the vodka as I cruise. I listen to heavy metal and get my money from a specific ATM. I fold the bills in the shape of a triangle and place it in my left pocket. I wear spandex pants and dark sunglasses. It makes me feel aroused."

Intricate rituals are the norm for sex addicts. Understanding and flushing out all of the ritualized components are crucial if an addict is to move toward healthy sexual expression; each of the components is a potential trigger of cue that could send the addict back to his behaviors. The client could see a cup from the same car wash. He could hear a song he plays while cruising. Going downtown for work, he could drive by his favorite corner, or he could smell vodka.

For the acting-in, or deprivation, side of the cycle, rituals give way to distancing strategies, which can include picking a fight, making oneself unattractive, criticizing or shaming one's partner, staying busy, staying up late, medical or physical excuses such as "I have a headache; it's that time of the month," and so on. All of these strategies serve to elicit the same result: avoidance of sexual contact.

Acting in or acting out is often not the most powerful aspect of the cycle. It is sometimes the shortest part of the cycle, whereas the majority of the time and energy goes into the planning for and ritualization of the behavior. No matter where the addict seeks his most intense high, the results are always the same: feelings of shame, guilt, remorse, and despair that prompt the addict to tell himself, "I will never do this again." However, the guilt, shame and remorse drive him back into the only coping mechanism he knows: acting out. Thus the cycle continues until the addict's life becomes unmanageable or, as they say in twelve-step meetings, he "hits a bottom."

Hitting a bottom is a very personal experience -- what you think may be a bottom for a person may not be nearly the level of pain and consequence he or she can tolerate. This is sometimes the saddest part of my work -- when a client sits before me and facts what I perceive as horrendous consequences: losing a job, partner filing for divorce and selling their home, losing visitation rights with children. Still, addicts are prisoner to the cycle.

No matter how one acts out or in, the issues and results are the same: a
cycle of disruptive behaviors that becomes unmanageable and can include
serious and often life-threatening consequences.

The cycle is the same for all forms of addictive behaviors. The cycle, as we we have explored, is based or grounded in a profound sense of shame and self-loathing. The shame drives the individual to take action, or move away from the pain of these feelings. The behavior used to numb the feelings of pain is based in trauma and formulated or created early in a person's life.

Patrick Carnes, in the book, Out of the Shadows, explains this cycle. He states that, from the place of shame, an individual moves into impaired thinking, rationalization, or denial to justify his behaviors. The distorted thinking becomes automatic, like breathing. Addicts are often not aware of their justifying thoughts because the pattern has become embedded as their emotional coping mechanism. They tell themselves, "Just one more time. I am not hurting anyone. I deserve it." This rationalization gives them the green light to proceed with their behavior. Once they have given themselves permission, they will become preoccupied with the acting in or out.

This period of preoccupation creates the chemical infusion in the brain that brings great pleasure. Chemicals such as dopamine, serotonin, adrenaline are released. For some addicts, the thinking about, planning, and anticipation of the behavior is the most pleasurable part of the cycle. When they are in this state, they are in a trance; they feel no pain. They have literally created a chemical cocktail that is as addictive as any drug.

Wednesday, September 25, 2013

Janis is an usually active child who, in her adult years, will be diagnosed with Attention Deficit Hyperactive Disorder (ADHD). She is a handful for her parents, who have five other children. Janis's mother has no time for close supervision of her offspring.

At the age of three, Janis has taken to climbing onto the kitchen counters, over the backyard fence, up into the trees. Once her parents had to call the fire department to get her down.

Janis's mother masks her fear for Janis's safety by raging. "She used to spank the hell out of me," Janis explains.
"I know she was just afraid something would happen to me," Janis continues, "but the spankings were daily, on so were the screaming and yelling."
"What would you say?"
"Oh, she'd tell me I was a bad girl, stupid, no good, a thorn in her side, stuff like that."

When a child is spanked, especially on the bare bottom, the vibration of the impact can resound and stimulate the child's genitals. The pleasure is then merged with the pain, creating a template wherein pain and pleasure are fused.

"To try and keep me safe, she would tie me up," Janis continues.
"How would she do that?" I ask.
"Well, she used a harness and would hook it to the clothesline, so I could slide up and down the line, but was restricted by the length of the cord tied to my waist. Or she would tie my hand or my leg to the playpen or crib."
"What was that like for you?""Well, at first I was furious, and then I was humiliated, especially when my brothers and sisters had friends over. Then I would tethered to the clothesline like some wild animal. If I cried or complained, my mom would come out and hit me some more."

It is dark in the dungeon as Janis puts on the finishing touches of her outfit, readying herself for her first trick of the night. She can feel the anticipation of her first session.

Her heart beats rapidly, and her mouth is dry, her breath shallow. Janis is already high as she tied the final knot into the harness.

Janis is a dominatrix. She re-creates the horrors of her childhood in her sexual torture chamber; only this time, Janis is in control.

"Sometimes I go too far," Janis says with a distant look.
"How so?" I ask.
"I just get into it that I lose track of where I am. I just want more intensity, more pain, more humiliation. They will yell for me to stop, and I can't. I just keep going. Sometimes I scare myself. It makes me wonder what I'm capable of doing."
"Are you the top (sado, the giver) or the bottom (the maso, the receiver)?" I ask.
"Both."

In entering a sexual encounter, Janis does not expect nor want a loving, nurturing experience. For her, a sexual act requires danger, risk, pain, and humiliation. Janis does this because it is hardwired into her.

"Have you ever orgasmed without pain?" I ask.
"No, nor without being humiliated," she tags on as if it were an afterthought.
"I also get a better high when I am with a woman," Janis explains.
"Why do you think that is?"
"I am sure that it's because of my mother. I remember the hate I felt for her, and that's how I feel when I do a session with a woman."

Attraction to same-sex partners is often confusing for heterosexuals; however, it is not uncommon. Addicts' choices for acting out mirror their original trauma, which often leads to behaviors that do not necessarily reflect their authentic sexual selves.

For Janis, understanding the orientation and preferences is vital for her healing process. First, it will reduce her confusion and second, it will reduce her feelings of shame. Once Janis realizes her reenactment is a mirror image of her abuse, the power will diminish, and so will the high.

"You ruined it for me," Janis says with a slight smile.
"How so?" I ask.
"You took all the fun out of it."
"You mean, once you understood why you were doing the behavior, it no longer provided the high?"
"Yes, not only does it not work, it disgusts me," she says to her own surprise.

The high that once masked Janis's shame has been replaced by her ability to feel and be present. No longer a robotic caricature of her abuse, Janis can be her true self and find healthy sexual expression.

Tuesday, September 24, 2013

"Well, I always look for women who are somewhat wild, someone who looks like a party ready to happen," Chet says with a slight chuckle. "You know, the one who can't get enough, who wants to do it all the time, anywhere, swing from the chandeliers... you get the idea."
"Yes, I do," I say with a slight nod.

Chet, a partner in his law firm, has found himself in several compromising situations. Seeming himself as "helpful," he likes to mentor many of his young associates -- usually the ones who wear tight, short skirts.
"So the past few relationships you have been in are all with women who work for you?" I ask.
"Yes, I know it's bad," he says, pausing. "But they are always coming on to me, and what can I say? I want them to do well, to be successful, so I help them out--obviously, in more ways than one?" he says with another chuckle.
"Do you think this is funny?" I ask.
"Funny? No, why?"
"Then why do you keep chuckling?" I ask.
"Because it can get so crazy."

Chet, like many who act out, is in a great deal of denial. He sees himself as a victim of the wiles of women. He feels that he's the pawn, being manipulated by their sexual come-ons.

It is a sunny, warm day as Chet plays with his toy cars in the front yard. Chet's mother, fastidious about her flower beds, is out pruning and weeding. The two, engrossed in their own worlds, are startled by the loud honk of the car driving by. Chet looks up in time to see a man hanging out of the window, ogling his mother. His mother, secretly thrilled at the attention, responds with a coy smile and a wave.

"It made me sick," Chet says with some force. "would get so mad at those guys, I wanted to kill them."
"That is a strong reaction."
"I was really pissed," he says with continued force.
"At whom?"

Chet pauses a moment, taking a mental inventory. "I thought it was the guys, but I guess it's my mom."

Chet's feelings of shame, fear, and anger are in his throat as he watches his mom flirt. Looking over his shoulder, she moves toward the back door, shouting to Chet, "I'll be back in a few." She presses her finger to her lips, indicating that this is a secret best kept from Chet's father.

"Did she know these fellows?" I ask.
"I don't know," Chet says, shrugging his shoulders.
"Had this happened before?"
"Yeah, it had: she would just take off," Chet says with agitation in his tone.
"How would you feel?"
"Freaked out."

Chet is morbidly attracted to women over whom he can pull rank. He acts as the sexual predator his mother once appeared to be.

Children are extremely sensitive to energy. They are instinctual beings tuned into what is happening around them. It is a survival trait, and it's is instinctual. For Chet, experiencing his mother's behavior was a traumatic event for several reasons. First, she was acting without appropriate sexual boundaries. Her lack of containment allowed her sexual energy to spew all over Chet like a burst fire hydrant. Chet, unable to articulate what he was feeling, knew on some level that his mother's behavior was dangerous, and a betrayal to him and his father. He felt shame and fear, and yet he had no voice.

The unconscious messages his mother sent Chet about sex were many: sex equals power and attention, sex is dangerous, sex is a weapon, sex is a tool, sex is objectification, sex is secretive. Her behavior and nonverbal cues were the recipe that created Chet's sexual template. He learned his mother's lessons well.

Monday, September 23, 2013

Exploitative sex is an overt act of power and control over someone who is vulnerable, such as the recently divorced mother of three, the salesperson depending on the boss for advancement, the person with a mental or physical disability, the college student who needs tutoring from her professor, the frail and the elderly, or the child.

Usually the sexually compulsive abuser does not see himself as being exploitative; rather, he views himself as being supportive and helpful.

Chet sits in my office. He is impeccably groomed. With crisp, articulate speech, he describes the recent breakup with his partner that has brought him in for counseling.
"What do you look for in a woman?" I ask.
"That's the problem," Chet says with a sheepish expression. "I always get myself in trouble."
"How so?"

Sunday, September 22, 2013

Mark pulls his car around the back of the building where there are few parking spaces left. He pulls on his baseball cap, despite the fact it is well past midnight.

The place is jumping as he open the wooden door fashioned to look like something out of the OK Corral. Mark beelines for the back room, much seedier than the front. He knows the drill and is eager to get started.

Mark will act out in what are called "glory holes." These are holes drilled through walls that allow penetration by the erect penis. One can be either the receiver or the giver. One man sticks his erect penis through while the man on the other side fellates him. It is dangerous, anonymous sex because neither man knows what is waiting for him on the other side, in terms of both pain and disease.

"When you heard the the diagnosis, what happened for you?" I ask.
"I was humiliated."
"This has happened before?" I ask.
"Twice," Mark says, unable to make eye contact.
"Despite this humiliation, you have been unable to stop. Do you understand why?"
"Yes," he says, looking up. "It is the need to dump my anger at my drunk, perverted uncle," he says with force.
"But now you are the pervert?" I ask.
"Yes, I am the pervert," he says, letting out a long sigh.

Although Mark does not sexually assault young boys, his re-creation of the original trauma gives him the illusion of control. He is now the instigator, however, the high of becoming the perpetrator rather than the victim does something to heal the endemic sickness of the continual need for dysfunctional self-assertion.

Like many of the acting-out behaviors we will discuss, this type of acting-out carries with it a great deal of stigma. Often these individuals are seen, as Mark sees himself, as rejects, or as vile and dangerous characters. These stigmas only compound the addict's shame and confusion. "Why do I choose this kind of secret life? What is wrong with me that I have this kind of secret life? Why not affairs or prostitutes, like other guys? I could never tell anybody this stuff."

As we have explored, it is vital for addicts to understand there sexual templates. This part of the healing process is always fascinating. We locate and piece together the complete picture, like a puzzle needing assembly. When addicts can see the logic behind their choices of acting-out behaviors, their shameful feelings diminish. They no longer see themselves damaged products of childhood wounding. Now they will be able to walk through the shame and embrace the wounded part of the self, despite having been driven into shameful behavior, now can be restored to hope and self-esteem.

Friday, September 20, 2013

Anonymous sex is high-risk sex that traumatically replicates the danger posed to the child by his original perpetrator. The differences is that, in adulthood, he has become the violator in order to take power and control. It is likely that the sexual element of the danger was intense, which is how danger, sex, and intensity became fused in his sexual template.

Mark sits in the outer office of the clinic. The stark lighting irritates his eyes, and the hard chairs remind him of the demoralizing predicament that has driven him here, rather than to the comfortable office of his family practitioner.

An attractive, tall, tanned, toned, blond man in his early thirties, Mark is a stark contrast from the other patients in the waiting room. In polished Italian loafers, a designer suit with a white silk shirt, and a fashionable, abstractly patterned tie, he has the air of success.

Mark glances at his watch for the third time in five minutes. He is eager to get his appointment over because he is confident he already knows his diagnosis. Mark is all familiar with the crushing blow that comes with the doctor's words. Like a verdict being handed down from the high court, it is something he would rather forget.

Mark can hear his uncle snoring in the twin bed across the room. He can also smell the alcohol and cigarette smoke that emanate from his breath. Uncle Joe, deemed "the biggest loser" by Mark's mother, landed on their doorstep a few days ago, jobless and broke. Mark's dad, Joe's older brother, took pity on him and agreed to help Joe get "back on his feet."

Uncle Joe's temporary lapse in snoring allows Mark to drift back to sleep. Always a sound sleeper, Mark is confused and disoriented when he is awakened again, this time by something probing his face. Still half-asleep, Mark tries to brush it away; however, this time Mark is awake enough to realize it is his uncle's penis. Mark is frantic, but his uncle restrains Mark's movement, making it impossible for him to break free. Mark feels as if he is suffocating, as if he might die, as if the violence will never end.

"Gonorrhea," Mark's doctor says. "I'm sorry to tell you, but that's what you've got."
Mark stares straight ahead as the words wash over him like a bad dream.

For Mark, the damage of his traumatic sexual wounding is a high-risk sexual addiction that is about power and control rather than sexual titillation. His high comes from the mastery over the original wounding. The problem is that, every time Mark acts out, he feels shame and is like to sum up the feeling as self-loathing.

"Oh, it was awful. I was so embarrassed, but I didn't stop."
"What makes you want to get help now?" I ask.
"A lot," Jake says. "I feel like such a pervert. You just don't know what it is like to live your life trying to get a peek. It feels so desperate, so all-consuming."
"I can imagine," I say.
"I don't know how to be in a relationship. I spend all my free time either voyeuring outside or on the Net. It has ruined my life, and now I face these charges. I should have my whole life ahead of me... " Jake says, his voice trailing off.
"Do you understand why you act out in this way?"
"Oh yeah," Jake says with the confidence and enthusiasm of a schoolkid.
"I understood when I drilled the first hole in the bathroom wall. I felt the rush, the high, the power. I knew it was wrong, but I couldn't stop then. Can't stop now. That's been my whole life."

As a child, Jake adapted to the original wounding by creating a fantasy world in which he would escape stress and shame. Whether it is peeking under dresses in a car lot or cruising the Internet for pornography, Jake's behavior is all bout his original trauma. The voyeur has adapted to avoid the emotions associated with the original wounding act.

Thursday, September 19, 2013

Jake is awakened by a low moaning sound, which turns to shortened gasps for air. Afraid and confused, he allows the glare of the streetlights to guide him down the hallway. The noise changes again into deep gutteral sounds, as if someone is being hurt or tortured. Tiptoeing to the threshold of his partents' room, Jake is riveted by the outline of his mother's body, entwined with a man who is not his father. Jake's confusion merges with curiosity as he watches his mother writhe and moan.

Intuitively Jake knows this is not meant for him to see. This forbidden voyeurism is immediately seared into his memory, creating a disturbing clash of emotions. On one hand is Jake's desire to worship his mother. On the other, he retains a picture of her as a sexual outlaw who inculcated him with shame in the face of sexual pleasure. This pleasure is fused to the danger of having spied on her, risking exposure.

This powerful forbidden experience is among Jake's first intimate sexual memories, and it will traumatize him.

A heterosexual boy who sees a naked woman is going to be aroused, but there's a problem when she is his mother. It is pleasurable, but it is bad. It is pleasurable, but it is secretive. It is pleasurable, but it is shameful. When Jake seeks sexual gratification, the sex will have to be secretive, bad, shameful and as intense as incest.

The high for voyeurs is hardly ever the orgasm itself. The high is what surrounds it -- what re-creates that original trauma: the danger, secrecy, and risk of being caught. That is when Jake feels safe and comfortable, back with Mother. But this time, it is okay -- except for the inevitable shame, which is killing him emotionally.

Jake sits in my office, still resembling the gawky child he has described to me. Only twenty-five, Jake has been arrested three times for the passive, violent act of voyeurism. The court has ordered him into treatment, and he is eager to get help.

"I want to stop," Jake says with conviction.
"Then you can," I say. "That's the first step to change: the willingness."
Like many compulsive people, sex addicts craft their lives to fit their addictions, and Jake is no exception.

"They have a really hot band at the hotel, so tonight is going to be a wild one," Jake's manager says to the parking-lot attendants where Jake works. "I want somebody on their toes. So let's roll," his boss says, clapping his hands.

The headlights of the cars heading for the rock concert cut through the darkness as Jake readies himself to open his first car door. As the car slides to a stop, Jake reaches for the doorknob, his heart beating fast and blood pumping through his veins as if he were in the middle of a boxing match.

"So in college you were a parking-lot valet?" I ask.
"Um humm," Jake says, nodding his head.
"Tell me how you acted out in this situation."

Jake knew these hot, balmy nights brought the best possible odds. Long, tan legs slid open as they exited the cares in short skirts. Jake would strain to catch a glimpse of lacy panties or perhaps no panties at all. Tonight Jake knew his odds were good; it was usually the case when the band played. Jake knew the patrons would be particularly raunchy.

"What would you do when you voyeured the women?" I ask.
"Well, I would take a snapshot in my head and save the images until I got home and then masturbated. Sometimes I'd make up stories or fantasies about them."
"To create more intensity?" I ask.
"Yes."

Although the voyeur is passively distancing himself from any intimate contact, he is, at the same time, unilaterally and aggressively appropriating sexual privilege. The culmination of the peeping maybe in orgasm during the watching, or the orgasm may be delayed until the voyeur, having stored up his images, masturbates in privacy. When the pleasure is delayed and played out with stored images or euphoric recall, the template behind it has to do with an early childhood adaption to fantasy. This will lead to a search for the origins of such an adaption in childhood.

Voyeurism is a subtle form of empowerment without intimacy, and this is precisely how Freud analyzed it. To watch unobserved is to appropriate lives and assert oneself over one's victims. "Those who observe become ours, hostages to our eyes," wrote Sigmund Freud. The voyeur becomes master of what he survey, so watching becomes not only the origin of excitement, but also a remedy for pain, a reward for success, and a means for maintaining emotional balance. When in the grips of this obsession, the voyeur, even during acts of bodily sex with a real-life partner, will have to imagine a fantasy in order to reach orgasm. Real intimacy becomes impossible.

"Then your progressed into peeping into dorm windows?" I ask Jake.
"Oh, I had been peeping in windows since I was eleven; in college was the first I got caught."
"Were you arrested?"
"No. It was just campus security, and they just gave me a slap on the hand," Jake explains.
"What was it like, when you first got caught?"

Wednesday, September 18, 2013

Although the voyeur is passively distancing himself from any intimate
contact, he is, at the same time, unilaterally and aggressively
appropriating a sexual privilege. The culmination of the peeping may be
in orgasm achieved during the watching, or the orgasm maybe be delayed
until the voyeur, having stored up his images, masturbates in privacy.
When the pleasure is delayed and played out with stored images or
euphoric recall, the template behind it reflects an early childhood
adaption to fantasy. This will lead to a search for the origins of such
an adaption in childhood.

It is mid-August, and the
air hangs like thick velvet curtains. These are the dog days of summer,
but Jake, who sits on the curb outside his four-story row house, is
oblivious to the humidity. He is buried deep in this imagined world,
dragging his stick across the sewer grate, magically transforming it
into banjo strings, like the banjo his father plays on weekends in the
pub on the corner.

"Hey, Jakey," his friends yell from down the street.
Jake, jolted out of his imagined world, attempts to intercept the softball flying by his head.
"Got ya," they tauntingly jeer, cracking themselves up with laughter.
"You're such a pussy," the ringleader says.
Jake, who has taught himself not to react to the jabs, picks up the ball and tosses it back.
"Where's the stick?" another boy asks.
Jake averts his eyes in self-reproach. "Forget it," he says and turns to climb up the stoop of the tenement.
"Wait here, guys," Jake says over his shoulder, but the boys, right on his tail, follow Jake into the dark, dingy foyer.
"Who's there?" his mother calls out.
"Just me, Ma," Jake says, knowing she is on one of her afternoon binges.
Turning the corner to enter the living room, Jake stops, and boys run into each other.
"Shit," Jake mutters under his breath.
"What?" What are you doing?" Jake's mother asks, slightly raising her head and then letting it fall.

Spread out in panties and bra, her mother says in a slurred voice, "Oh, hey, boys; come on in," sh wave her extended arm.
The boys quickly turn away in fear and disgust. "We'll meet you outside," one of the boys says, slamming the screen door.

Jake's
mother's shameless behavior has been a constant throughout his ten
years of life. An alcoholic like her husband, she has often passed out
by mid-afternoon, lying naked or half-clad in an open robe or a
revealing nightgown.

Jake is torn about his feelings for
his mother. When his mother, still a beauty, is sober, she is loving and
attentive, but these times are few and far between. More often, she is a
sloppy, abusive, neglectful drunk, and that's what Jake has come to
expect from her.

Jake blinks at the bright sunlight as he
steps out onto the stoop. He hearts the boy's snickers as he leaps down
to the sidewalk. "Let's go," he yells, attempting to deflect humiliating
taunts and putdowns. Jake, already adept at emotional survival, has
learned to manipulate situations to avoid feelings of shame. Jake stuffs
those feelings deep down into the cavern of his core, when they will
eventually morph into the anger that fuels his secret life.

Jake's experiences with his mother's abusive behavior are the nucleus for his sexual template. The anger, blame, shame, fear, arousal, excitement, and curiosity all fuse in a confusing and overwhelming transfiguration that fuels his compulsive sexual behavior.

Jake, like all voyeurs, is aroused through visual stimulation. Because of the physical distance and anonymity from which it is committed, voyeurism is a passive-aggressive acting-out behavior. This kind of passivity-cloaking aggression has its origins in the original childhood wounding, when the child's shame reaction to abuse needs to be camouflaged so as not to invite further abuse or even ostracism.

We have already cussed, passive aggression is a common trait in most acting out sexual behaviors, because such behaviors seek to replicate the conditions under which the original wounding took place -- but with one critical change: The victim of the original abuse becomes the perpetrator. He seeks the power and control he did not have as a child. It becomes his unconscious motivation to repeat the behaviors that were perpetrated for resolution and a feeling of safety.

Tuesday, September 17, 2013

As a culture, we then to stigmatize certain sexual acts or behaviors. If a person's sexual templates and related behaviors lie in the less understood, acceptable, or unforgivable realms, recovery can prove even more of a challenge. The associated shame makes it that much more difficult to own, talk about, treat, or heal. I am not saying that we should condone such behavior, but that we should educate ourselves about the compulsiveness that generate it.

Voyeuristic Sex

Voyeurs are aroused through the visual stimulation, and voyeurism is a passiveness-aggressive acting out behavior. This kind of passivity-cloaking aggression originates at the time of the original childhood wounding, when the child's angry reaction to abuse needed to be camouflaged as as not to invite further abuse. Passive-aggressive is a common trait in most acting out behaviors, because such behaviors seek to replicate the conditions under which the original wounding took place -- with one critical change: The victim of the original abuse becomes the perpetrator. He seeks the power and control he did not have as a child, which he delusionally believes, will bring him pleasure and safety.

Friday, September 13, 2013

With all addictive behaviors, there is a cycle or pattern that is predictable and ritualized. For the healing process to begin, it is paramount for the individual to understand and intervene in this cycle.

As addicts, we have learned to live in extremes: extreme behavior, extreme thoughts, and extreme feelings. We live this way because unconsciously we are attempting to gain control or achieve moderation. It is much like a pendulum that swings from one side to the other, never stopping or finding a sense of balance or moderation.

This is the life of the sex addict, a roller coaster life of emotional imbalance. The goal of treatment and sexual health is learning to live a moderate, balanced life.

Those who "act out" express their sexualized anger overtly. Those who "act in" suppress their sexualized anger. As in the acting-out cycle, the acting-in cycle is motivated by the desire to gain power and control over traumatic memories, in order to avoid the loss of control, fear, and shame that the memories provoke.

When those who act in are provoked by memories of their original wounding, they become obsessed with strategies to protect against losing control over their bodies. These strategies distance them from sexual involvement. They become preoccupied with keeping their sexual distance that they become hypervigilant, fearful, and almost panicky.

They develop distancing strategies such as coming home late from work so they do not have to face their spouses. At the sign of sexual signals from their partners, they may pick a fight. When it is time to go to bed, they may make up a project that is too engrossing to put down. They may get too drunk for sex.

They sometimes make themselves physically unattractive by dressing badly. Men will not shave; women will not wear makeup. They do not bathe or use deodorant. They were their unattractiveness like body armor.

It is a sad irony that those who act in take pride in these sexual deprivations. They are in denial that their distancing and self-abnegation are founded on a basis of shame. So, instead of feeling one-down, they go one-up by convincing themselves that they have developed an admirable discipline that makes them superior to the loose, immoral, irresponsible sexual indulgences of those who act out. they are like food addicts who can constrain themselves from eating but think that all fat people are disgusting. Their one-upmanship is really a projection of their own low self-esteem around the fear of losing sexual control.

Acting in and acting out can alternate with one another. A client may tell me he doesn't act out for six months, but then he binges on cocaine and pays a dozen prostitutes in a weekend. These extreme swings dysfunctionally provide addicts with the feeling that they are in control of their excesses, and they prove it by their temporary returns to deprivation. Whether in the binge or deprivation side of the cycle, they have the illusion of being in control when in reality they are out of control. Moderation, an essential part of a healthy emotional life, is beyond them.

Acting-out individuals are subject to long periods when they alternate between acting out and false recovery, which is acting is masquerading as recovery. After a period of destructive acting out, individuals wills come to a recovery facility and accept a celibacy contract. After treatment, they rigidly adhere to sexual deprivation and do not have sex for possibly three years. In another scenario, a woman divorces from a marriage in which both partners had been sexually acting out. For the nest five years, she has no sex. Now, instead of acting out, she is acting in. The goal in recovery is to be moderate, to learn to live neither in excess or deprivation.

This cycle of acting out alternating with acting in characterizes many dysfunctional relationships between husband and wife or other committed partners. Usually one is a love addict and the other is a love avoidant. A lot of people enter relationships that sex equals love. Love addicts think that sex will prove they are worthwhile. Love avoidants think that, by providing sex, they are doing their caretaking duty, which their immature, needy parents taught them was the meaning of love.

When they find that they are miserable despite the sex, their fantasies about love and sex are shattered. the love addict acts in and shuts down sexually. Her knight in shining armor has failed her. The other partner, the love avoidant, resents this deprivation and now has an excuse to get sex outside the painful relationship. He hates being dutiful.

The acting-out partner has probably unconsciously picked the acting-in partner because, as a love avoidant, he considers love a painful duty, and he senses how desperately his partner needs love. Fulfilling this desperate need give him the power upon which his self-importance rests. Now, when the pain of deprivation is manifested, he can do what he always wanted to do: act out sexually with no relationship obligations. He develops a resentment that his partner is not available to him, and he believes he is fully justified in getting what he wants outside their relationship.

If both partners are acting in, the relationship can go on forever. I do not see a lot of acting-in couples in treatment. They seem happy, and their dysfunctional emotions are well hidden. They have grown very familial with their acting-in behavior, and they think it is normal. The calm is shattered when they get into a relationship with someone who demands that they be sexual and emotionally vulnerable. Then they realize that they really do have a problem.

when both partners are acting out sexually, chaos often ensues. One method of controlling the sexual chaos is by trying to normalize it, making it part of an accepted routine. This is common with people who go to swingers' clubs. They tell themselves that the club is as normal as a bingo game or a night at the movies. They tell each other that it is fun and exciting. They engage in threesomes and role-play dress-up.

Acting out can become intense and life-consuming as it becomes the basis of what a couple thinks their relationship is all about. Often both partners are acting out outside of the primary relationship, sometimes with the permission of their partners. This can seem comfortable and in control until someone gets arrested, gets a disease, or is publicly condemned. Then there is a crisis.

In the middle of these mutual acting-out cycles, one of the partners may swing into acting in. If the acting-out partner gets caught, he might swing over to the acting-in side. Or I have known acting-in people who have found out that their partners are having multiple affairs and then, in resentment, act out. It is not necessarily their propensity, but their form of retaliation. When their acting-out partners discover that are being "betrayed," they are devastated and my choose sexual deprivation, swing back to acting in.

Thursday, September 12, 2013

It is a crisp fall day as Barbara shuffles through the dry oak leaves that lie like a carpet in the field behind her apartment. The heavily wooded lot has become Barbara's escape, a sanctuary for her imaginary world.

An only child to a single mom, Barbara is starved for attention. Her mother, who holds down two jobs to make ends meet, is exhausted on weekends and has little time to spend with Barbara. Barbara knows nothing about her biological father -- only that "he was a bad mistake and a distant memory."

Her cousins who live down the street, eight years older than six-year-old Barbara, often taunt and tease her, calling her "Bastard Barbara." She is often sent there to spend the night when her mother works late.

Barbara fights off the loneliness and shame that stalk her by escaping into her mind. In her fantasies, Barbara is never alone: She is the object of desire, a treasured princess. The tall, dark trees come alive; they are her admirers, her lovers.

In this fantasy, Barbara is in control; she has the power. No longer a victim, she is the desired object, and she mainlines the euphoric drip of her imagined world.

Barbara, a petite, freckled redhead whose voice is surprisingly commanding, has come into treatment to examine her unsuccessful relationships.

"Did your fantasies have a theme?" I ask.
"Yeah, they did," she says. "I was always hurt; usually I was in a car accident, and some handsome paramedic would rescue me. The minute our eyes met, we were in love. Our encounter would lead to passionate lovemaking."
"How long did your fantasy last?" I ask.
"For years."
"Did the fantasy ever deviate?"
"Only in small details. In the winter, when it was too cold to go outside, I would play in the basement. Down there were the columns that supported the building, and I substituted the columns for the trees. When I went to school, I would do the same thing in the orchard next to the playground."
"You wouldn't play with the other kids?" I ask.
"Not usually. I liked my fantasy world. I spent so much time in it, I had a hard time relating to other kids."

This kind of reliance on fantasy is a form of dissociation trauma, which enables the victim to separate from the reality of what she is feeling. Barbara had found an escape from her desperate need for love and attention. In her mind, she was desired, she was loved, and, most important, she had control.
"What did it feel like when you went into your fantasy?" I ask.
"It was like slow molasses pouring over me -- a sweet, luxurious euphoria that made all the pain go away."
"How long did the fantasy last?"
"Until I came in here for treatment," she says matter-of-factly.

For fantasy addicts, fantasy becomes part of their identity, a reflex as automatic as breathing. The dependence on this escape can become so severe that the idea of giving it up feels like the death of an old intimate friend. Often the withdrawal with fantasy addicts face is extreme because of the immediate loss of the chemicals induced by the chemically-altered brain. Living in the "here and now" immediately releases an overwhelming flood of feelings. The fantasy addict feels disoriented, overwhelmed, and desperate to escape back into familiar fantasy, where he feels he has control.
"How do you think your fantasy world has affected your relationships?" I ask.
Barbara lets out a spontaneous laugh, which surprises her.
"Everything outside my fantasy world is so boring. I love that I can create whatever I want, in whatever scenario I want, whenever I want. Riding the train home from work, changing my son's diapers, having sex with my boyfriend... my fantasies are always more exciting than my everyday life."
"So it is the desire for intensity that the fantasy creates."
"Yes, and the fact that nothing or no one can live up to my fantasy world. I am always in control."
"So it's that need to be in control, to have all the attention, to feel special, that makes it hard to let go?"
"Yes," Barbara says as tears flow down her cheeks.

Relational intimacy, both emotional and physical, will not be possible for Barbara until she lets go of the fantasy drug and grieves her traumatic childhood. Like all addicts, she needs to become present in the here and now, allowing the intensity of her private world to fade away.

Wednesday, September 11, 2013

Fantasy sex is one of the most powerful and challenging behaviors to treat because the addict has created a 24/7 IV drop. Whenever the addict wants to escape or get high, he opens the drip and there is instant relief. When I am training therapists, I ask them to think of their favorite food. Chocolate is often the answer. I ask them to think of the specific type of chocolate: dark, milk, bittersweet, etc., then to imagine opening the package, the sound of the crinkle of the paper, the first whiff of the aroma, snapping of the first piece, placing it in their mouths, experiencing the texture and the taste.

They are now in a chemically altered trance state. The detailed sensuous recall of the chocolate bar has induced the chemicals in the brain that create a high. This is similar to what happens for a fantasy addict when he imagines his sexual vignettes.

Often the fantasy addict has one particular fantasy, of theme of the fantasy, that has been with them since the fantasy began: His is rescued, he is in control, he is in physical pain, he is desired. The fantasy can vary. However, the same fantasy, or slight variations on the theme, can be with addicts their entire lives.

Friday, September 6, 2013

Running into her father's arm, she squeezes him with all her might. "Okay, okay, sweetie, now Daddy needs to see what's happening in the game," he says, and pushes her off her lap.

Maxine's father was emotionally unavailable. Instead of being there for Maxine, he acted out sexually in drunken and drugged stupors.

In our culture, women tend to be flirty and needy, offering full surrender, whereas men tend to be caretakers, seductively generous from the one-up stance, while, at the same time, most women have been emotionally disempowered and feel they need a man to take care of them on an emotional level. They develop passive-aggressive techniques to get what they want by appearing vulnerable. They flaunt their neediness as a seduction technique. Because, in our culture, men have been falsely empowered to think they need to take care of needy women, it feeds their grandiosity to give until they get bored.

Both love the avoidant, who avoids intimacy through grandiose caretaking, and the love addict, who avoids intimacy through neediness, use sex to manipulate their partners in order to compensate for their own emotional delinquencies. Each feels a painful lack of self-esteem. Because our self-esteem cannot be given to us from the outside, manipulating our partners so that their love will make us whole is not only a fruitless task, but evidence of our childhood wounding.

"What I learned from my father," Maxine says with sadness in her voice, "was to abandon myself. I wanted him so much. I ached for his attention, and where did it get me?" she says with tears flowing down her face. "A bunch of sick relationships, with a bunch of sick men, all of whom could give a shit about me... every last one of them, just like my father."
"So what do you need to do now?" I ask.

Maxine looks at me blankly, her eyes red and swollen, her body rolled onto the couch, clutching the pillow in a near-fetal position. "I need," she says in a childlike tone, "someone to love me." Her tears continue to flow.

In successful therapy, the avoidant and the addict will discover that the would from which they both suffer is abandonment. Neither got the kind of parenting that supported belief in his or her authentic humanity. They were taught that they needed something other than what they were. The avoidant was taught to feel less than (needy), the addict taught to feel more than (grandiose). Both feelings are lies that have made inevitable the confusion of self-esteem with one-down and one-up manipulation.

"Do you think you can love yourself?" I ask Maxine.
"Good God," Maxine say, sitting up. "That's what it all comes down to, doesn't it?" she says with some resolve.
"Yes, it does, unless you want to live in the constant shadow of your father's abuse."
"Well, I've done that for long enough, and look where that's gotten me," she says.
"Yes, and look at where you could go from here," I say.
"Yeah, " Maxine says with a quick smile, her body more relaxed. "Look where I could go from here." Her smile widens. "To a lot better place than where I've been."

Thursday, September 5, 2013

Let's recall the story of Maxine, who, as an "official party girl," found sexual power and control. Maxine's father, a successful trial lawyer, was Maxine's hero. Smart, articulate, charming, attractive, and commanding, he seemed to be the center of whatever would he entered.

Everything Maxine achieved, she did for her father's approval. A straight-A student, captain of the basketball team, and homecoming queen, she was fueled by an unrelenting drive to be perfect.

It was hard for Maxine to fall asleep, despite the late hour. She could hear the party below, from which she had been dismissed several hours ago.

There were heavy drinking and drug use, naked people in the hot tub, whipped cream being licked off of woman's breasts. Her father was ringleader of it all.

"Where was your mother during these parties?" I asked.
"She was there with everybody else," Maxine says matter-of-factly.
"She was participating?"
"Yes. My parents were unofficial swingers."
"What do you mean, 'official'?"
"Well, they never want to clubs or anything like that -- at least I never knew about it -- but they had an open marriage for a while."

Maxine creeps down the staircase to get a better look. A stripper has arrived, an obvious birthday present for her father, and she had climbed on top of the dining-room table.

"My dad was mesmerized," Maxine says, "He was positioned so I could see the expression on his face. He looked like was whooping it up, like all the rest of them."
"How did you fee, watching his response?" I ask.
"I was shocked. I mean, she wasn't that good a dancer, or that attractive, so I was surprised he was so into it."

Maxine hears the thunder as she pulls out her dress-up clothes. The rain is beating on the picture windows as she makes her way down the stairway. She joins her father, who is nursing his hangover in the den. He lets out a low moan as the opposing team scores another touchdown. "What the hell?" he yells, holding his throbbing head.

Maxine, absorbed in her production, positions herself in front of the TV.

"Watch me, Daddy," Maxine says, as she spins and gyrates, throwing off her pink boa.

her father strains to see the replay of the game between her frantic movement. "Oh, sweetie, you are one sexy lady," he says distractedly.

Maxine continues dancing, as her father, more attentive when the commercial begins, starts to laugh.

"Maxine, where'd you learn to be so sexy? Come here. You're Daddy's princess, aren't you?" For a fleeting moment, Maxine feels like a star. She feels as if the heavens have shone a spotlight on the two of them.